HomeMy WebLinkAbout10293699 - PermitAssessofs Parcel 408462-04 Lotr 69
Bldg: Address Range
Block NA Tracl 2207 Historic: No
city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cAg27o2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
Altoration
Alter/demo/nv
Sfd Wattached Garage
R-3, U
VB
cBc 2016
x-0602320257J
1
Patio:
T.l.Area:
Yards Req'd:
Valuation: $1,000.00
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
Description of Work: Remove unpermitted 2nd dwelling unit at rear yard with attached patio cover
Planning Conditions It
Owner:
Address:
Phone:
Tenanl:
HOANG TRAN
1514 W SAINT GERTRUDE PL
Santa Ana, CA 927045108
(714146'.t-2678
Contractor
Address:
Owner-Builder
Engineer
Address
Phone:
State Lic #i
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Hfi$I
Expires:
Phone;
License #
Architect /
Desiqner:
Address:
SUCn; . r
Planning Approval By
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd
Landscaping lnsp. Req'd
Amsden, Julie
Da|€: 0A10212017
Date:
Oale: 0810212017
Subject to Field:
Misc. Receipt
Misc. Receipl
Misc. Receipt
Fire lnsp. Req'd:
Police lnsp. Req'd
Flood Zone Cert. Req'd: No
o 777600 2
017760 0 2
077 760 0 2
o 777600 2
077760 02
071760 0 2
$154.26
$93.17
$234.08
$1.00
$21.25
$52.98
01 1 16002 51600
01 1 16002 51601
01 't 16002 51612
$21.2s
$534.49
$1.00
57607
57607
57 607
57672
57600
s7 607
Permit Fee
lnvestigalion
Penalty
Bldg. Stds. Revolving
General Plan Update
lssuance*
{.,Jo
No
No
No
No Account#Total
Every permit issuod shall become invalid unless the wo* on the site authoized by
such pemil is cofimenced within 180 days aftor its issuance,or il the wod< authonzod
on tho site by such pemil is suspended or sbandoned tor a pedod of 1 80 days after
tho lime the wo* is commenced
lnspector MtD# 2017-137776
$556.74
$0.00
$556.74
Permit #: {0293699
Pin #: {6E35
Proiect Address: 1514 W St Gertrude Pl Unit Suite Range:
Zoning: Rl
1st FL Area: 0
2nd FL Area: 0
Other Areas: 0
Garage Area:
Total: 0
Nel i:'7 i iiii
Phone:
License #
b 1(}50iirt
V iso
i.i i;
Orozco. lvan
Fee Total:
Paid to Date:
Balance Due:
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS o\INER BTJII-DEX DEI,('AIATION
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llruciue Fior ro ilJ iarM.q rb. ra|un6 ltc rpllicer for ruch Daml ro fik . .i8n d eddd rhd lE or ih. ir licmi.d pursier
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Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Roof Sheathing
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handica p Req
Deputy Final Report
Engineer Final Report
FINAL {'2217 v.tLJlb)
Certificate of Occupancy U
Notes Remarks, Etc.
;r""-'*",9-2-- /7
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N4AYOR
Maguel A. Pulido
MAYOR PRO TEM
Michele Martinez
COUNCILMEMBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
Sal Tinarero
Juan Villegas
INTERIi,4 CITY MANAGER
Cynthia J. Kurtz
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
PLANNING & BUILDING AGENCY
20 Civic Center Plaza
P.O. Box 1988 . Santa Ana, California 92702
www.santa-ana.orq i oba
NOTICE TO PROPERTY OWNER
Dear Property Owner
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specifled at
A
We are providing you with an Owner-Bu ilder Acknowled m nt n ln rm rifi rm to make you aware of
your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder.
We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned
this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property
owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT AN D VERIFICATION OF INFORMATON
DIRECTIONS: Read and initial each statement below to signify you understand or verifur this information.
+IL1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder' building'pefihil lhat enoneously implies that the property owner is providing his or her own labor and material personally. l, as an Owner-
Builder, may be held liable and subject to serious flnancial risk for any injuries sustained by an unlicensed person and his or her
employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting
as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
l7-LZ. I understand building permits are not required to be signed by property owners unless they are responsible for the' co struction and are not hiring a licensed Contractor to assume this responsibility.
ftlS. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself' frorfi potential flnancial risk by hiring a licensed Contractor and having the permit filed in hisorher name instead of myown.
HJq. t understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
penhits and contracts.
t t /i-
l-u_s. I understand rf l employ or otheMise engage any persons, other than Califomia licensed Contractors, and the total value of
'my bonslruction is at least flve hundred dollars ($500), including labor and materials, I may be considered an "employeil under state
and federal law.
fr-LA I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal
govdrnment, withhold payroll taxes, provide workers' compensation disability insurance. and contribute to unemployment
compensation ofeach "employee." I also understand my failu re to abide by these laws may subject me to serious llnancial risk.
H ll . t understand under California Contraclors' State License Law, an Owner-Builder who builds single-family residential
struclures cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontractors and
the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed
general building Contractor.
fl lA t understand as an Owner-Builder iflsell the property forwhich this permit is issued, lmay be held liable for any financia I or
pdrsonal injuries sustained by any subsequent owner(s)that result trom any latent construction defects in the workmanship or
materials.
SANTA ANA CITY COUNCIL
mou do@sema-a.a oro
Mayor Pro Tem, Ward 2
mrmanrnez@sEnla 6na oro vsarm'e.ro6s3.la-anaoro 60ronc@sa.la-a.aoro dbonavrdesasanlaanaoro iv sas@sanla-ana oro str.6lero@sanr6-affi orc
CITY OF SANTA ANA
t t.{
ff_Lg. I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the' Unlted States Small Business Administration, the Califomia Department of Benefit Payments, and the Califomia Division of lndustrial
Accidents. I also understand I may contact the Calilornia Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752)or
www.cslb.ca.oov for more information about licensed contractors.
tt1-
fi_L10.1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party
'legally and financially responsible for proposed construction activity at the following
address:ffi
#lp
ffiIio"o
. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
le laws and requirements that govem Owner-Builders as well as employers.
I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have
on this form.
Licensed contractors are regulated by laws designed to protect the public. lfyou contract with someone who does not havea license,
the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a com plaint.
Youronly remedy against unlicensed Contractors may be in civil cou(. lt is also important for you to undersland that if an unlicensed
Contractor or employee of that individual or firm is injured while wofting on your property, you may be held liable for damages. lf you
obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verifying whether or not those Contractors are
properly licensed and the status of their workers' compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the
agency responsible for issuing the permit. ,Voae. A copv of the propertv owner's driver's license. form notarization. or other
verificalion acce able to lhe rs re uired to be nted when the rmit is issued to ve the o er's
siqnature.
Signature of Property Owner Date ?/z/ / 7
Print name of Owner
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the
following person(s)to act as my agent(s)to apply for, sign, and flle the documents necessary to obtain an Owner-Builder Permit for my
Scope of struction Proiect(or
p
PLin k:W P51
ption of Work)
Project Location Address
Name of Authorized nt:
Address of Authorized Age
Phone Number of Authoriz Ag
I declare under penalty perjury that I a
ounterActivitylxssemblyBillslNotic
informaten and
Property Oilrngr
accuracy
's Si ature
Note: A copy the owner's driver's ,icense,
be presented en the permit is issued to
r the address listed abovc and I personzllly lllled out the above
Date:
ble to lhe agency is required lo
SANTA ANA CITY UNCIL
e
o Property Fonri
property owner
tion, or other verification ac
wner's signature.
Itc€nre S6n'enro
#mrdlo@sant!'ane m
P Oaud B6naedes
db€na$d6@samr-3n, nd sr'naao@srnll-ana do
<t'
Print Name of Owler:
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